Melanie Ramirez
New York ,United States
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Works effectively unsupervised and quickly mastering new skills.
Overview
12
12
years of professional experience
Work History
Hospital Care Investigator
New York City Health and Hospital Corp
The Bronx, NY
11.2017 - Current
- Successfully handled high caseload on strict schedule.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Applied HIPAA privacy and security regulations while handling patient information.
- Submitted appeals using provider portals and phone communication.
- Submitted claims to insurance companies.
- Checked claims coding for accuracy with ICD-10 standards.
- Managed all payments processing, invoicing and collections tasks.
- Provided support for workers compensation claims administration process including filing required documents with state agencies and tracking claim status updates.
- Reviewed and processed Forensic Rape Examination reports for the Office of Victim Services (OVS), ensuring accurate completion of required forms for timely submission to headquarters. Implemented detailed billing procedures to maximize reimbursement.
- Thoroughly reviewed and processed specialty claims including Tricare, ADAP, Christian Guardians Services, No Fault claims, and all workers compensation claims such as Uniformed Services such as NYPD, FDNY, and MTA claims.
Medical Records Clerk
Highland Medical Group
Nyack, NY
07.2016 - 10.2023
- Performed basic administrative duties by answering calls, taking messages, data entry, typing tasks and locating files upon request.
- Retrieved, sorted, copied and filed all documents and paperwork.
- Created or updated records with new files or information.
- Scanned images and documents with careful attention to clear scans and to correct document naming conventions.
- Retrieved documents and files from records rooms and online databases.
- Composed correspondence to internal and external company contacts.
- Answered questions about records or files.
Medical Assistant
Middletown Medical Group
Middletown, NY
08.2012 - 10.2014
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Measured vital signs and took medical histories to prepare patients for examination.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Organized charts, documents and supplies to maintain team productivity.
- Cleaned and maintained medical equipment following procedures and standards.
- Documented notes during patient visits.
- Responded to patient callbacks and phone-in prescription refill requests.
- Educated patients about medications, procedures and physician's instructions.
- Incorporated outside records into charts and EHR.
Education
Sandford Brown
White Plains, NYSkills
- Telephone Etiquette
- Applicant Support and Service
- Recordkeeping and Data Input
- Planning & Organizing
- Critical Thinking
- Reliable & Trustworthy
- Customer Service
- Fluent in Spanish
Languages
Spanish
Professional
Timeline
Hospital Care Investigator
New York City Health and Hospital Corp
11.2017 - Current
Medical Records Clerk
Highland Medical Group
07.2016 - 10.2023
Medical Assistant
Middletown Medical Group
08.2012 - 10.2014
Sandford Brown
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